Provider Demographics
NPI:1578509162
Name:STANGL, ANNA M (SLP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:STANGL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1460 CURVE CREST BLVD W
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6070
Mailing Address - Country:US
Mailing Address - Phone:651-439-8283
Mailing Address - Fax:651-439-0576
Practice Address - Street 1:1460 CURVE CREST BLVD W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6070
Practice Address - Country:US
Practice Address - Phone:651-439-8283
Practice Address - Fax:651-439-0576
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP50112OtherHEALTHPARTNERS
MN46-00967OtherMEDICA
MN377M5CAOtherBCBS-MINNESOTA